REINFORCED ACCESS TO HEALTH AND PROTECTION SERVICES IN HAITI

In April 2021, the new COVID-19 variants began spreading globally, with more than 800,000 new cases every day, the rate of death became higher in many countries reaching 13,000 new deaths worldwide every day in early May 2021. Haiti seems to have been lucky for the first year of the pandemic, with a low rate of new cases and a total of 263 deaths until the end of April 2021, although case numbers are not reliable due to a lack of testing and consistent data collection. Considering the numbers in the neighboring Dominican Republic and the porosity of the border between the two states, it is likely to think that the effects of the pandemic in Haiti were much greater than officially stated. From 72 confirmed cases of COVID-191 in May 2020, Haiti is now at 14,037 cases of infection, 292 deaths and 12,509 recoveries that have been confirmed1. Nevertheless, according to the MSPP, 66 new cases have been registered from May 1st to May 5th; data representing a big increase compared to the numbers of previous months and clearly indicating a new ongoing vague. On May 14th, 2021 MSPP confirmed the presence in the country of two COVID-19 variants, namely the British and Brazilian one. The arrival of variants presents a major challenge to the already weak Haitian health system as the implementation of the MSPP procedures took much longer than what was initially planned (triage station, isolation area, use of PPE, etc.) to be integrated. In addition, according to the Humanitarian Response Plan 2020 (HRP), more than 2.3 million people in Haiti are in need of humanitarian assistance in the health sector, including more than one million children and 315,000 pregnant women.  

This project Theory of Change (ToC) implies that IF access for the population to basic health needs including access to SRH services in the targeted areas is protected, IF HF and among families prevent COVID-19 spreading by the adoption of good WASH procedures and practices and IF frontline workers and population increase their sense of well-being and feeling of coping, THEN there will be an increased protection against COVID-19 and its health and social impact for the most vulnerable population of the West and Nippes departments.

This is why this project focuses primarily on the Health sector to prevent contamination through the COVID-19 virus. Even more with a gradual decline in the use of health services in Haiti and reflects a significant lack of confidence by the population in its health system, which is not performing well, does not offer the desired response to health problems, and remains difficult to access overall. The departments of the West, and in particular the areas of Cité Soleil and Martissant, and Nippes are experiencing a similar situation. Nippes (23.6%) was among the departments, according to this 2018 report, where the population had the least attendance at health institutions together with the West department (25.5%). This is why this additional support will be brought to support the health system to ensure continuity of essential health services in the West and Nippes departments (Intermediate Outcome 1) and to support MSPP infection prevention and control (IPC) activities for COVID-19 in the West and Nippes departments (Intermediate Outcome 2). DoTW will provide support and training to health care workers, CBO and traditional birth attendants on PPE, COVID-19 detection and isolation protocol and IPC standards in line with national protocols and guidelines. Maintain the HF temporary isolation rooms and triage stations (Phase I). Organizes joint supportive comprehensive supervision from Health Directorate and DoTW on PHC, GBV and SHR. Organize trainings on Gender-Based Violence principles and Clinical Management of Rape (CMR) to health facilities in recognition of increased risks posed by the outbreak. This project will also support the Ministry of Public Health on the referral pathways in line with national protocols and guidelines and with community-based outreach activities on COVID-19 prevention measures (including vaccines benefits). DoTW will supply essential medicines, medical supplies, and equipment to supported Health Facilities.

The fight against COVID-19 in the targeted departments in Haiti cannot neglect one of the important sectors of this fight which is the Water, Sanitation and Hygiene sector. Indeed, as shown in the latest EMMUS VI survey (2017), the majority of households (74%) have access to an improved source of drinking water, this being understood as tap water, public taps/fountains, pumped wells, boreholes, dug wells, protected springs and rainwater, this percentage drops to 60% in rural areas. In addition, the availability of hygiene products such as soap, chlorine, etc. is limited and further reduces the adoption of good hygiene practices. Although access to water is somewhat more widespread in health institutions, the existing equipment is sometimes defective, and the management of these systems is sometimes deficient. Therefore, the project will reinforce health institutions (HF) and families’ capacities to use adequate WASH procedures and measures (Intermediate Outcome 3). DoTW will distributes WASH kits to families and realizes community-based activities addressing COVID-19 barriers measures as hand washing. With the HF, maintenance of water supply and small rehabilitation of pipes to ensure proper water supply will be realized.

Finally, the Protection sector is of major importance in the context of strong stigmatization linked to the COVID-19 in Haiti, and in the context of the socio-political crisis that the population is undergoing. In particular, women that are facing great challenges in relation to a net increase of GBV. The latest data available on the impact of COVID-19 in Haiti (2020 Haiti Humanitarian Needs Overview (HNO) of the United Nations) show that 816k of survivors are hardest hit by abuse, violence, exploitation, and exclusion. Considering these analyses and field observations, the project will help to increase frontline workers, patients’, and their families’ capacities to deal with COVID-19 and insecurity related stress (Intermediate Outcome 4). DoTW will train health care workers on psychological principles and support the provision of basic psychosocial support related to COVID-19 and to frontline workers, patients and their families as well as GBV victims, according to the situation.